University of Virginia School of Medicine
Curriculum Committee
Minutes – 12/01/11

Pediatric Conference Room, 4:00 p.m. 

Present (underlined) were: Gretchen Arnold, Robert Bloodgood, Megan Bray, Chris Burns, Donna Chen, Eugene Corbett, Thomas Gampper, Donald Innes (Chair), John Jackson, Keith Littlewood, Nancy McDaniel, Mohan Nadkarni, Bart Nathan, Linda Waggoner-Fountain, Bill Wilson, Mary Kate Worden, Thomas Jenkins, Long Vinh,  Sam Zhao, Courtney Chou, Debra Reed  (secretary)

Present (underlined): A quorum was present.

1. GI System Review - The System Leader response from Drs. Behm and Shah listed goals for the February/March 2012 GI System. The Curriculum Committee approved and will follow up after the 2012 session.
   
   

   1.	Refine learning objectives working with faculty, students and system leaders
   2.	Provide practice questions to students during the system
   3.	Increase the percentage of active learning sessions during the system
   4.	Increase clinical faculty participation in physiology & pharmacology sessions
   5.	Add and refine questions for formative and summative exams
   6.	Develop better discrimination within the class with refined test questions

   
   
   Strength of System
   The GI system leaders have worked diligently to provide a system that is integrated and flows well during the system duration.  We have arranged the weeks to cover four general themes (luminal- upper GI, luminal- lower GI, liver, pancreaticobiliary).  Each week generally starts with the basic sciences, builds onto clinical engagement activities and ends with active learning problem set, small group discussions, and/or Team Based Learning session to solidify material learned during the week.
   
   Since the inception of the NxGen curriculum we initiated combined sessions pairing basic science faculty in several areas with clinicians to help provide an informative and interactive learner - centered experience.    
   
   Our system utilizes faculty from over 14 different departments with 67 faculty (GI and Hepatology, Pharmacology, Physiology, Anatomy, Pathology, Pediatrics, Surgery, Radiology, Internal Medicine, Bioethics, Microbiology, Immunology, Genetics, and Dentistry)
   
   Our system was very well received by the students in its first year and we hope to continue that success and improve on the short-comings we note below.
   
   Areas for improvement
   Increase active learning methodologies and learner-centered curriculum towards 60% goal.
   Curriculum observers reported 29.24% and students report 51.11% active learning in 2011. We plan to increase active learning in the GI System by taking the following action steps:
    

   *	Setting for each participating Thread the same 60% active learning goal that SOM set for the overall System. This will ensure all Threads contribute to reaching this goal.
   *	Expanding team-taught interdisciplinary sessions.
   *	Encouraging faculty to participate in SOM faculty development activities designed to improve their ability to successfully bring active learning to the classroom.
   *	Encouraging faculty to meet with SOM Instructional Designers to promote adaptation of appropriate teaching methodologies. We are particularly interested in assistance helping our faculty reduce didactic lecture time by taking advantage of pre-recorded lectures and think-pair-share in the classroom.
   *	Working with faculty to help them develop learner-centered classes and share feedback from students on different teaching activities throughout the system.
   *	Increasing the number of Team-Based Learning (TBL) activities in our system from the 1 we had in 2011 to 2 in 2012/2013. We look forward to working with the TBL group, once it is formed, to make TBL a success across our curriculum.
   *	Integration/sequencing of content In 2011 GI brought together over 7 threads into the system. This provides a basis for re-aligning the content between disciplines to fill gaps, remove unnecessary redundancies and unsuitable content, and to further integrate. Faculty are interested in working together and promoting integration. Having executive summaries from observers on the content covered in each session would help identify the common themes between systems.
   *	Learning objectives, resources, and multiple-choice questions Students report that the learning objectives and their related resources were a weakness of the system that we plan to improve next year. In addition to further faculty development in this area, we think instructional designer review of the reading material and educational sessions would help ensure the learning objectives are properly covered in the learning objectives.  This is an ongoing process and should be started with the end of the system until the following year.
   *	Improvements in multiple-choice questions used for practice, quizzes, and exams will require additional support because materials are not readily available from outside sources. We will need support from the Office of Medical Education.   The system leaders have continued to create additional test questions using outside resources and have modified multiple test questions submitted by other faculty to bring them to the current standards.  We should also consider protecting time for people with knowledge in the field of GI to assist with the creation of new test questions.

      
   
2. Clerkship Update from the Clinical Medicine Committee (Bill Wilson)
   
   The “overlap period” in the clerkship year that will begin Feb. 27, 2012 and last for 8 weeks was a primary topic of discussion.  The clerkships were encouraged to plan as much as possible in advance. The rosters for both Block 6 for the class of 2013 and Block 1 for the class of 2014 are available through OASIS, and has allowed for some tentative scheduling of specific students.
   
   Passports and the “ED-2” list. John Jackson reported that UVA has been in contact with the developer of OASIS, and an electronic version of the passports that could be signed off on an iPhone or iTouch may be available by the start of the upcoming clerkship year. This would allow for attending and resident physicians to “sign off” on passport items using an electronic method and could eliminate the need for the paper passports. At present, the content of the passports for the individual clerkships would remain the same, although the potential for revising the passports and possibly merging the passports and the ED-2 lists needs to be discussed. The future may bring an “integrated passport” that would follow the student longitudinally through the clerkships.  John Jackson has compiled the ED-2 lists from all of the clerkships and this will be circulated to determine if there are gaps or unnecessary redundancies in the lists.
   
   Expectations for skills acquisition on the clerkships and prior to graduation Several skills that were formerly attainable during the clerkships are much less so now, due in part to changes in technology and the availability of different therapeutic modalities.  The list that was compiled by Dr. Corbett may be helpful in defining what skills should be taught and mastered, and when in the curriculum should a given skill be taught.
   
   The Transition Course for the Class of 2014 will take place Feb 13-24, 2012, and will include EPIC training for those students as well as some of the workshops that currently occur during clerkships. Drs. Keeley, McDaniel and Peterson are organizing the course.
   
   
3. Clerkship Learning Objectives There is a need to more specifically link the learning objectives for the clerkships to assessments. This may be done using online quiz assessments of knowledge, but the assessments of clinical skills and attitudes may be more difficult to achieve. An “OSCE” at mid-year, possibly tailored to a given student’s clerkship exposures, was considered.
   
   
4. Immediate feedback follow-up – There were no problems from the pre-Thanksgiving examination. Students were very appreciative.

Donald J. Innes, Jr., M.D.
dmr